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Flashcards in Abdo Deck (33)
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1

What to look for general inspection abdo

Vomit bowls
Forms of feeding
Drains
Overall nutrition
Tattoos- ask aswell about bruises

2

What to look for hands abdo

Clubbing
Palmar erythema
Dupuytren contracture

3

What is dupuytren contracture and what does indicate

Knots of tissue form under tissue leading it to become tense and pull down finger- flexion

4

What to be careful about with dupuytren contractures

Can be from use of tools especially power drilling

5

What can cause dupuytren contractures

Alcohol
Idiopathic

6

What to look for in arm abdo

Needle marks- BBVs
Bruises- less clotting factors- liver
Fistula from haemodialysis
Leukonychia
Kolionychia

7

What to check for in eyes abdo

Sclera icterus
Conjuctival pallor

8

How to assess sclera icterus in black person

Get to look up

9

What is kolionychia

Spoon shaped nails

10

What is leukonychia

White discoloration of nail

11

What to look for mouth abdo

Glossitis
Cushingoid face
Ulcers
Candidiasis
Hydration

12

What is candidiasis

Yellowing of tongue- fingal infection

13

How to inspect neck abdo

JVP
Full node examination including left supraclavicular node- virchows

14

What does enlarged virchows node indicate

Gastric malignancy

15

How to inpsect chest abdo

Look spider naevi
Scars
Gynaecomastia

16

What to look for abdo inspection for abdo

Scars
Distension
Caput medusa
Pulsations
Cullens sign
Grey turners sign
Striae

17

What are caput medusa

Looks like snakes under chest (enlarged epigastric)- caused by portal hypertension

18

What is cullens sign

Bruise colorisation of anterior abdomen

19

What is grey turners sign

Bruise like appearance of lateral abdomen

20

What causes cullens and grey turners signs

Intraperitoneal bleeding from acute pancreatitis

21

How to palpate abdomen

Ask if in any pain
Light palpation to begin with in each of 9 areas- make sure kneeling at abdomen level and look out for pain grimacing
Then do deep palpation looking for masses- try to cup skin, pinching fingers into palm
Next palpate and percuss for liver- BREATHE IN
And now same for spleen
Ballot kidneys
Check for AAA

22

What is further percussion required and how to do

Shifting dullness
Percuss from umbilicus to left flank until changes from resonant to dull and pinpoint this with finger and get patient to roll over onto side towards you- now percuss this area and see if still dull

23

What does shifting dullness indicate

Ascites

24

Where to ausculate abdo

Just lateral to umbilicus- bowel sounds. Check description?
Superolateral to umbilicus to hear for bruits in renal artery
USE BELL

25

Final check on abdo exam

Sacral and feet oedema

26

What say would do at end of abdo exam

Check hernal orifices
Examine genitalia
Urine dipstick

27

Order to abdo exam

General inspection
Ask about tattoos bruising
Inspect hands
Asess liver flap
Radial pulse
Check BP
JVP
Nodes
Inspect eyes
Inspect mouth
Chest inspection
Abdomen inspection
Ask to lie flat
Light palpation
Deep palpation
Liver palpation
Liver percussion
Spleen palpation
Spleen percussion
Kidney balloting
Check AAA IF OK
Percuss for shifting dullness
Ausculatate bowel sounds
Auscultate bruits
Check for oedema
Conclude

28

What can clubbing in abdo exam suggest

UC
IBS
Cancer

29

What does leukonychia suggest

Hyoalbuminaemia- liver issues

30

What does kolionychia indicate

Iron deficient anaemia